Faith Formation Registration Thank you for registering for Faith Formation Classes. Step 1 of 3 33% Child (Children's) Last Name(Required) Father Name(Required)Religion(Required)Marital Status(Required) Married Single Divorced Father's Address(Required) Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Father's Phone Number(Required)Father's Email(Required) Mother Name(Required)Religion(Required)Marital Status(Required) Married Single Divorced Check If Same As Father's Address(Required) Yes No Mother's Address(Required) Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Mother's Phone Number(Required)Mother's Email(Required) Emergency Contact Name(Required) First Last Emergency Contact PhoneChild's Name(Required) First Last Sex(Required) Male Female Date of Birth(Required)School Child Attends(Required)Grade Level(Required)Baptized(Required) Yes No Baptism Date and Location(Required)First Confession(Required) Yes No Previous Religious Instruction(Required) Yes No If yes, where did you take the religious instruction at?(Required)Any Medical Problems/Allergies?(Required)Learning Disabilities?(Required) Yes No Do you need to add another child?(Required) Yes No 2nd Child's Name(Required) First Last Sex(Required) Male Female Date of Birth(Required)Grade Level(Required)School Child Attends(Required)Baptized(Required) Yes No Baptism Date and Location(Required)First Confession(Required) Yes No Previous Religious Instruction for child 2(Required) Yes No If yes, where did you take the religious instruction at?(Required)Any Medical Problems/Allergies?(Required)Learning Disabilities?(Required) Yes No Do you need to add a 3rd child?(Required) Yes No 3rd Child's Name(Required) First Last Sex(Required) Male Female Date of Birth(Required)Grade Level(Required)School Child Attends(Required)Baptized(Required) Yes No Baptism Date and Location(Required)First Confession(Required) Yes No Previous Religious Instruction for child 3(Required) Yes No If yes, where did you take the religious instruction at?(Required)Any Medical Problems/Allergies?(Required)Learning Disabilities?(Required) Yes No Are you a registered parishioner?(Required)YesNoPlease select.(Required)I understand all fees are non-refundable. If your child(ren) is recieving a sacrament (First Communion / Confirmation) there is an additional fee. Please contact Lana Pierre to take care of this payment. I understand the fees. Select Number of Children(Required)1 Chilid $352 Children $453 Children $554 Children $65How are you paying?(Required)Cash or CheckCredit Card Name First Last Email Billing Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Total Payment MethodPayPal CheckoutCredit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name Δ
